Provider Demographics
NPI:1891781787
Name:SOUTH CENTRAL MONTANA REGIONAL MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:SOUTH CENTRAL MONTANA REGIONAL MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTERMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-252-5658
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59103-0219
Mailing Address - Country:US
Mailing Address - Phone:406-252-5658
Mailing Address - Fax:406-238-3617
Practice Address - Street 1:1245 N 29TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0122
Practice Address - Country:US
Practice Address - Phone:406-252-5658
Practice Address - Fax:406-238-3617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CS701326OtherRR MEDICARE GROUP NUMBER
CD-1841OtherRR MEDICARE GROUP NUMBER
MTVENDOR #0177769Medicaid
MTVENDOR #0216125Medicaid
MTVENDOR #0216121Medicaid
MTVENDOR #0216112Medicaid
MTVENDOR #0177775Medicaid
MTVENDOR #0177786Medicaid
MTVENDOR #0216104Medicaid
M000008008Medicare PIN
MTHSP270011Medicare ID - Type Unspecified
MTHSP270049Medicare ID - Type Unspecified
MTVENDOR #0216104Medicaid